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NPI Code Detail

MEDICARE: GINA LANORE GWERDER ARNP

MEDICARE: GINA LANORE GWERDER ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP61354263WA

General Provider Information

NPI Number : 1619697380
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA LANORE GWERDER ARNP
Provider Business Mailing Address
First Line : 19505 SE 384TH ST
Second Line :
City : AUBURN
State : WA
Zip : 98092-9755
Country : US
Telephone Number : 253-508-4141
Fax Number :
Provider Business Practice Location Address
First Line : 853 WATSON ST N
Second Line :
City : ENUMCLAW
State : WA
Zip : 98022-3948
Country : US
Telephone Number : 360-768-4045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2022
Last Update Date : 09/01/2022

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